scholarly journals Reviewing recordings of neonatal resuscitation with parents

2021 ◽  
pp. fetalneonatal-2020-320059
Author(s):  
Maria C den Boer ◽  
Mirjam Houtlosser ◽  
Ruben S G M Witlox ◽  
Roosmarijn van der Stap ◽  
Martine C de Vries ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Medical Center ◽  
Qualitative Interviews ◽  
Neonatal Resuscitation ◽  
Parental Experiences ◽  
Respiratory Parameters ◽  
Positive Experiences ◽  
Set Up ◽  
And Coping ◽  
Gestational Age At Birth

BackgroundRecording of neonatal resuscitation, including video and respiratory parameters, was implemented for research and quality purposes at the neonatal intensive care unit (NICU) of the Leiden University Medical Center, and parents were offered to review the recording of their infant together with a neonatal care provider. We aimed to provide insight in parental experiences with reviewing the recording of the neonatal resuscitation of their premature infant.MethodsThis study combined participant observations during parental review of recordings with retrospective qualitative interviews with parents.ResultsParental review of recordings of neonatal resuscitation was observed on 20 occasions, reviewing recordings of 31 children (12 singletons, 8 twins and 1 triplet), of whom 4 died during admission. Median (range) gestational age at birth was 27+5 (24+5–30+3) weeks. Subsequently, 25 parents (13 mothers and 12 fathers) were interviewed.Parents reported many positive experiences, with special emphasis on the value for getting hold of the start of their infant’s life and coping with the trauma of neonatal resuscitation. Reviewing recordings of neonatal resuscitation frequently resulted in appreciation for the child, the father and the medical team. Timing and set-up of the review contributed to positive experiences. Parents considered screenshots/copies of the recording of the resuscitation of their infant as valuable keepsakes of their NICU story and reported that having the screenshots/video comforted them, especially when their child died during admission.ConclusionParents consider reviewing recordings of neonatal resuscitation as valuable. These positive parental experiences could allay concerns about sharing recordings of neonatal resuscitation with parents.

Benefits of recording and reviewing neonatal resuscitation: the providers’ perspective

2018 ◽  
Vol 104 (5) ◽  
pp. F528-F534 ◽  
Author(s):  
Maria C den Boer ◽  
Mirjam Houtlosser ◽  
Elizabeth E Foglia ◽  
Ratna N G B Tan ◽  
Dirk P Engberts ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Medical Center ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Successful Implementation ◽  
Care Providers ◽  
Educational Benefits ◽  
Staff Members ◽  
Objective Feedback ◽  
Qualitative Data Analysis Software

ObjectiveTo assess benefits of recording and reviewing neonatal resuscitation as experienced by neonatal care providers.DesignA qualitative study using semistructured interviews questioning neonatal care providers about their experiences with recording and reviewing neonatal resuscitation. Data were analysed using the qualitative data analysis software Atlas.ti V.7.0.SettingNeonatal care providers working at neonatal intensive care units (NICUs) of the Leiden University Medical Center, the Netherlands, and the University of Pennsylvania School of Medicine, USA, participated in this study.ResultsIn total, 48 NICU staff members were interviewed. Reported experiences and attitudes are broadly similar for both NICUs. All interviewed providers reported positive experiences and benefits, with special emphasis on educational benefits. Recording and reviewing neonatal resuscitation is used for various learning activities, such as plenary review meetings and as tool for objective feedback. Providers reported to learn from reviewing their own performance during resuscitation, as well as from reviewing performances of others. Improved time perception, reflection on guideline compliance and acting less invasively during resuscitations were often mentioned as learning outcomes. All providers would recommend other NICUs to implement recording and reviewing neonatal resuscitation, as it is a powerful tool for learning and improving. However, they emphasised preconditions for successful implementation, such as providing information, not being punitive and focusing on the benefits for learning and improving.ConclusionRecording and reviewing neonatal resuscitation is considered highly beneficial for learning and improving resuscitation skills and is recommended by providers participating in it.

scholarly journals Simulation-Based Education in the Training of Newborn Care Providers—A Malaysian Perspective

2021 ◽  
Vol 9 ◽  
Author(s):  
Kwai-Meng Pong ◽  
Jerrold Tze-Ren Teo ◽  
Fook-Choe Cheah
Keyword(s):  
Neonatal Intensive Care ◽  
Ad Hoc ◽  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Care Practice ◽  
Care Providers ◽  
Educator Training ◽  
Simulation Based ◽  
Set Up

Simulation-based education (SBE) is increasingly used as an education tool to improve learning for healthcare providers. In newborn care practice, SBE is used in the Neonatal Resuscitation Program (NRP) and training in procedural skills. The NRP is a mandatory course in Malaysia for all house officers (interns) and medical officers (residents) during their pediatric rotation. Almost 30,000 of NRP providers have been trained over the last 5 years. The recent establishment of the Allied Healthcare Center of Excellence (AHCoE), an organization dedicated to promoting SBE, and Malaysian Society for Simulation in Healthcare (MaSSH) aims to enhance the integration of SBE into the healthcare training curriculum and set up a local healthcare simulation educator training program. Our experience in implementing SBE necessitated that we made several important choices. As there was no strong evidence to favor high-fidelity over low-fidelity simulation, and because simulation centers can be very costly to set up with limited resources, we chose SBE mainly in the form of low-fidelity and in situ simulation. We also identified an important developmental goal to train Malaysian instructors on structured debriefing, a critical activity for learning in SBE. Currently, debriefing is often carried out in our centers at an ad hoc basis because of time limitation and the lack of personnel trained. Finally, we aim to implement SBE further in Malaysia, with two axes: (1) the credentialing and recertification of physicians and nurses, and (2) the education of lay caregivers of high-risk infants before discharge from the neonatal intensive care unit.

scholarly journals Psychosocial, emotional and professional challenges faced by female healthcare professionals during the COVID-19 outbreak in Lahore, Pakistan: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sumbal Shahbaz ◽  
Muhammad Zeshan Ashraf ◽  
Rubeena Zakar ◽  
Florian Fischer
Keyword(s):  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Working Environment ◽  
Cultural Issues ◽  
Self Reflection ◽  
Professional Challenges ◽  
Proper Training ◽  
Phenomenological Methodology ◽  
Novel Coronavirus ◽  
And Coping

Abstract Background The novel coronavirus disease (COVID-19) is spreading rapidly, increasing the stress and challenges for healthcare professionals around the world. This study aims to discover the psychosocial, emotional and professional challenges faced by female healthcare professionals (HCPs) treating COVID-19 patients in Pakistan. Methods Using an empirical phenomenological methodology, semi-structured telephone-based qualitative interviews were conducted with 22 female HCPs who were providing their expertise for COVID-19 patients in tertiary-level hospitals in Lahore, Pakistan. Purposive sampling was used for recruitment. The interviews were conducted between 20 July and 20 August 2020. The interviews were analysed using thematic analysis. Results This study explored the psychosocial, emotional and professional challenges faced by female HCPs serving COVID-19 patients. Five themes were observed in the interviews: apprehension while treating COVID-19 patients; feelings towards COVID-19 patients; challenges as female HCPs and coping strategies; confidence in government, administration and self-reflection; and finally, future concerns and recommendations. Many of these themes have also been linked with cultural issues, making the results specific to Pakistan. Conclusions During the COVID-19 pandemic, female frontline HCPs have faced immense psychosocial pressure, ranging from unsupportive family norms to an unwelcoming working environment and insensitive hospital administrations. Moreover, rumours among the general public, lack of proper training, missing incentives and improper system surveillance have increased the anxiety and stress among HCPs. Hence, legislators are advised to take appropriate actions countrywide in order to alleviate the still ongoing challenges and support female HCPs in their working environment.

Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit

2016 ◽  
Vol 25 (19-20) ◽  
pp. 2745-2756 ◽  
Author(s):  
Dua'a Fayiz Al Maghaireh ◽  
Khatijah Lim Abdullah ◽  
Chong Mei Chan ◽  
Chua Yan Piaw ◽  
Mariam Mofleh Al Kawafha
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Qualitative Studies ◽  
Parental Experiences

Randomised crossover trial comparing algorithms and averaging times for automatic oxygen control in preterm infants

2021 ◽  
pp. fetalneonatal-2021-322096
Author(s):  
Christoph E Schwarz ◽  
Karen B Kreutzer ◽  
Lukas Langanky ◽  
Nicole S Wolf ◽  
Wolfgang Braun ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Random Order ◽  
Target Range ◽  
Oxygen Control ◽  
Non Invasive ◽  
Fraction Of Inspired Oxygen ◽  
Averaging Time ◽  
Randomised Controlled ◽  
Gestational Age At Birth

ObjectiveAutomatic control (SPOC) of the fraction of inspired oxygen (FiO2), based on continuous analysis of pulse oximeter saturation (SpO2), improves the proportion of time preterm infants spend within a specified SpO2-target range (Target%). We evaluated if a revised SPOC algorithm (SPOCnew, including an upper limit for FiO2) compared to both routine manual control (RMC) and the previously tested algorithm (SPOCold, unrestricted maximum FiO2) increases Target%, and evaluated the effect of the pulse oximeter’s averaging time on controlling the SpO2 signal during SPOC periods.DesignUnblinded, randomised controlled crossover study comparing 2 SPOC algorithms and 2 SpO2 averaging times in random order: 12 hours SPOCnew and 12 hours SPOCold (averaging time 2 s or 8 s for 6 hours each) were compared with 6-hour RMC. A generated list of random numbers was used for allocation sequence.SettingUniversity-affiliated tertiary neonatal intensive care unit, GermanyPatientsTwenty-four infants on non-invasive respiratory support with FiO2 >0.21 were analysed (median gestational age at birth, birth weight and age at randomisation were 25.3 weeks, 585 g and 30 days).Main outcome measureTarget%.ResultsMean (SD) [95% CI] Target% was 56% (9) [52, 59] for RMC versus 69% (9) [65, 72] for SPOCold_2s, 70% (7) [67, 73] for SPOCnew_2s, 71% (8) [68, 74] for SPOCold_8s and 72% (8) [69, 75] for SPOCnew_8s.ConclusionsIrrespective of SpO2-averaging time, Target% was higher with both SPOC algorithms compared to RMC. Despite limiting the maximum FiO2, SPOCnew remained significantly better at maintaining SpO2 within target range compared to RMC.Trial registrationNCT03785899

scholarly journals Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

scholarly journals Accuracy of real-time delivery room resuscitation documentation

2018 ◽  
Vol 105 (2) ◽  
pp. 222-224 ◽  
Author(s):  
Claire E Fishman ◽  
Danielle D Weinberg ◽  
Ashley Murray ◽  
Elizabeth E Foglia
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Real Time ◽  
Vital Sign ◽  
Gold Standard ◽  
Neonatal Intensive Care ◽  
Video Recording ◽  
Neonatal Resuscitation ◽  
Delivery Room ◽  
Level 3

ObjectiveTo assess the accuracy of real-time delivery room resuscitation documentation.DesignRetrospective observational study.SettingLevel 3 academic neonatal intensive care unit.ParticipantsFifty infants with video recording of neonatal resuscitation.Main outcome measuresVital sign assessments and interventions performed during resuscitation. The accuracy of written documentation was compared with video gold standard.ResultsTiming of initial heart rate assessment agreed with video in 44/50 (88%) records; the documented heart rate was correct in 34/44 (77%) of these. Heart rate and oxygen saturation were documented at 5 min of life in 90% of resuscitations. Of these, 100% of heart rate and 93% of oxygen saturation values were correctly recorded. Written records accurately reflected the mode(s) of respiratory support for 89%–100%, procedures for 91%–100% and medications for 100% of events.ConclusionReal-time documentation correctly reflects interventions performed during delivery room resuscitation but is less accurate for early vital sign assessments.

Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?

2018 ◽  
Vol 46 (9) ◽  
pp. 1028-1034 ◽  
Author(s):  
Paola Algeri ◽  
Matteo Frigerio ◽  
Maria Lamanna ◽  
Petya Vitanova Petrova ◽  
Sabrina Cozzolino ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Doppler Study ◽  
Umbilical Artery Doppler ◽  
Nicu Admission ◽  
Twin Pregnancies

Abstract Objective: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. Methods: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study. Results: We found that twin pregnancies with inter-twin estimated fetal weight (EFW) discordance ≥15% were significantly associated with a higher risk of preterm delivery before 32 (P=0.004) and 34 weeks (P=0.04). Similarly, twin pregnancies with inter-twin abdominal circumference (AC) discordance ≥30° centiles were associated with a higher rate of neonatal intensive care unit (NICU) admission (P=0.02), neonatal resuscitation (P=0.02) and adverse neonatal composite outcome (P=0.04). Of interest, when comparing twin pregnancies according to Doppler study, growth restricted twins had a higher rate of composite neonatal outcome and in multivariate analysis, an abnormal Doppler was an independent risk factor for this outcome. Conclusions: Our study associated growth discrepancy with specific pregnancy outcomes, according to defined cut-offs. In addition, we demonstrated that an abnormal umbilical artery Doppler is independently associated with a composite neonatal adverse outcome in growth restricted fetuses.

scholarly journals Health prevention in youth sports: innovative and interdisciplinary experiences at the Lausanne 2020 Youth Olympic Games

2020 ◽  
Keyword(s):  
Sports Medicine ◽  
Role Model ◽  
Olympic Games ◽  
Political Support ◽  
Health Prevention ◽  
Youth Athletes ◽  
Positive Experiences ◽  
Set Up ◽  
Multiple Skills ◽  
Youth Friendly

The Youth Olympic Games were introduced in 2010 with the aim to bring young athletes not only an experience of competition on the world stage, but also to help them learn about the Olympic values, explore other cultures and develop the skills to become true ambassadors. The Lausanne 2020 Games provided an excellent opportunity to develop innovative concepts for health promotion and sports-related prevention. The enthusiasm across various sectors of society (political, academic and economy) empowered us to bring together multiple skills to materialize the IOC’s pledge. We developed communication concept around key sports-related issues targeting the competitors and population of our region. We set up pavilions hosting the various modules in Lausanne, at the Olympic Villages (Lausanne Vortex and St. Moritz), where the modules could be tested and videos were presented. Deep Impact is a virtual reality immersion into concussion, And You …? explores the perceptions of sports-related abuse through five excerpts of blockbuster movies. The Safety Clips for youth athletes introduce ten typical adolescent sports medicine topics in a youth-friendly format. Youth and elite (role model) athletes delivered the messages rather than professionals, whilst the content was true to current scientific knowledge. Three key elements emerged. 1. The power of interdisciplinarity and innovation to promote healthy sports. 2. Adolescence is the best time to sensitize athletes and their entourage. 3. The need for strong institutional and political support to develop health prevention in sport. We look forward to building on these positive experiences and bring prevention and health in sports forward.

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